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FAQs About Ketamine for Depression
IS KETAMINE SAFE?
Ketamine has been used as an anesthetic and pain relief medication in operating rooms for decades. It is a very safe depression medication in the hands of properly trained healthcare professionals. Anesthesiologists are the most highly trained physicians when it comes to the safe use of ketamine.
Its use as a treatment for depression, including treatment resistant depression, and other mental health conditions is at sub-anesthetic doses, below those necessary to induce general anesthesia. Ketamine is also frequently used to treat patients experiencing chronic pain conditions.
IS KETAMINE A RECREATIONAL DRUG?
Ketamine has been abused as a recreational drug. Street drug use is in doses vastly higher than the sub-anesthetic doses used for the treatment of depression and other mental health conditions. As mentioned above, ketamine is used legally and safely every day in the specialty of anesthesia and is a very safe medication in experienced hands. Incidentally, many the drugs used in anesthesia practice have the potential for abuse, so ketamine is not unique in this respect. The key is administering the right dose to the right patient in the right setting.
IS INTRAVENOUS KETAMINE THE ONLY WAY TO DELIVER KETAMINE FOR TREATMENT RESISTANT DEPRESSION?
There are many other ways to give ketamine: orally, sublingual, intranasally, and intramuscularly. Unfortunately, the effectiveness and predictability of response in these other routes are vastly inferior to intravenous ketamine. Additionally, most scientific studies of ketamine for depression and mental health conditions have been performed using IV Ketamine. In short, IV ketamine is the gold standard route for ketamine infusions.
CAN KETAMINE HELP ME?
Research over the last 5-10 years has shown that intravenous administration of ketamine in sub-anesthetic doses remarkably benefits 70% of people suffering from severe depression. While the benefits can truly be remarkable, they often occur in ways that differ from some patients' expectations. That is, the changes produced by ketamine can be subtle, and while they occur quickly, they do not always manifest themselves immediately. This phenomenon stands in contrast to some patients' expectations of a benevolent "thunderbolt" response from ketamine treatment. We will work closely with you to identify and evaluate the benefits of ketamine as a depression medication.
WHAT DOES THE RESEARCH SHOW ABOUT KETAMINE BENEFITS?
Check out this article from the National Institute of Mental Health for more information:
WHAT SHOULD I EXPECT DURING MY FIRST INFUSION?
After we have received your medical history and completed acknowledgement of ongoing care by a mental health professional or primary care doctor, we will schedule an initial consultation. At the initial consultation, if we decide that you are a good candidate for ketamine infusions, you are welcome to receive your first ketamine treatment that same day, in which case you should plan to be at our depression treatment centers for approximately 90-120 minutes.
The logistics are as follows: we will place an IV, apply monitors to enable us to record your heart rate and rhythm, blood pressure, and oxygen level continuously throughout the infusion, then we begin the infusion. The infusion itself takes about 45 minutes. Afterwards, we will monitor you for approximately 30 minutes before you are released with a friend or relative who can drive you safely home.
During the infusion, occasionally people experience nausea, mild non-threatening hallucinations, or dizziness. If you experience nausea, we are equipped to treat it with an IV dose of an anti-nausea medication.
You will be awake during the infusion and able to interact with those around you. It is best to relax quietly or listen to relaxing music during the infusion.
The effects of ketamine wear off quickly once the infusion is stopped, although we ask that you refrain from driving until the day after the infusion.
Please do not eat solid foods, milk, pulp-filled juices or soup for 4-hours prior to your appointment. You may have clear liquids such as water, Gatorade, apple juice, black coffee or tea up to two hours prior to your appointment.
HOW MANY INFUSIONS DO I NEED?
The standard ketamine infusion protocol for depression that has resulted from scientific trials and clinical experience around the U.S. is 4-6 infusions over a two-week period. We have found 4, rather than 6, initial infusions to be the highest yield. It has been shown that serial infusions are more effective than single infusions, and most patients who respond to ketamine treatment require maintenance infusions on an ongoing basis following the initial series. The frequency of these maintenance infusions varies greatly from person to person. It is important to note that ketamine infusions should not be viewed as a cure for depression, but rather a depression treatment that is a piece of a multi-modal approach that may include ongoing mental health therapy or other depression medication.
CAN I CONTINUE TO TAKE MY REGULAR MEDICATIONS?
Yes, you should not stop your antidepressant medications in order to receive ketamine. It is essential that we review your current medication list prior to beginning ketamine treatments.
IS KETAMINE ADDICTING?
Ketamine is not physically addicting but has been shown to be psychologically addicting in those using it recreationally at much higher doses and in far greater frequencies than we will use.